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NPI Verification

National Provider Identifier: 1225272412

Jordan D Dimitrakoff, M.d., Ph.d.

Individual Provider

Credentials

M.D., Ph.D.

Primary Specialty

Internal Medicine

Code: 207R00000X

All Specialties (5)

Internal Medicine

Code: 207R00000X

Internal Medicine, Adolescent Medicine

Code: 207RA0000X

Urology

Code: 208800000X

Internal Medicine

Code: 207R00000X

Primary

Urology

Code: 208800000X

Practice Address

330 BROOKLINE AVE KS-316

BETH ISRAEL DECONESS MEDICAL CENTER

BOSTON, MA 02215

Phone: 617-667-2051

NPI Enumeration Date

May 1, 2009

NPI Number

1225272412

Data sourced from the official CMS NPPES Registry. This information is provided by the Centers for Medicare & Medicaid Services and is updated regularly.

View on CMS NPPES Registry